What Makes Us unique

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Care in the Countryside

Mellor Nook is one of a very few care homes to be located in the green
belt. We take every opportunity to embrace and celabrate our rural situation

Family Run Bussiness

It is very unusual nowadays for a care home to be run by the same family
for over 30 years. More inportantly in our opinion is that we live here
on the premises. This is our home too

What people say

CQC inspector

" Mellor Nook is unique"

Doctors

"what a fantastic place to spend your retirment"

Relatives

"the staff are willing to go the extra mile"

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Safeguards

The aim of this guide is for Mellor Nook to promote good practice. One
important element of good practice is to guard against any kind of exploitation,
neglect or abuse of residents. An environment which is constantly seeking
to improve the life and care of residents automatically tends to guard
against bad practice.

In spite of registration, inspection, internal monitoring, quality assurance
systems and codes of practice, regrettably abuse can occur. Sometimes
this may be unwitting or unintentional perhaps through ignorance or neglect.
At other times, however, it may be deliberate, whether subtle or overtly
cruel. There is now greater recognition of the fact that abuse does occur
and a fuller understanding of how it arises.

The definition of abuse

'Elder abuse is a single or repeated act or lack of appropriate action
occurring within any relationship where there is an expectation of trust
which causes harm or distress to an older person.'

Action on Elder Abuse

Abuse is the harming of another individual usually by someone who is
in a position of power, trust or authority over that individual. The harm
may be physical, psychological or emotional or it may be directed at exploiting
the vulnerability of the victim in more subtle ways (for example, through
denying access to people who can come to the aid of the victim, or through
misuse or misappropriation of his or her financial resources). The threat
or use of punishment is also a form of abuse. Abuse may happen as a 'one-off'
occurrence or it may become a regular feature of a relationship. Other
people may be unaware that it is happening and for this reason it may
be difficult to detect. In many cases, it is a criminal offence.

Physical abuse

Rough handling or unnecessary physical force, either deliberate or unintentional,
used in caring for a resident is abuse. Injuries may not always be visible
although often there may be bruises, broken skin, cuts, burns or broken
bones. During an episode of abuse, damage to property or clothing may
also occur. Restraining residents so that they cannot move, or by shutting
them in a room, is abusive. However, it may sometimes be difficult to
draw the dividing line between justifiable and unjustifiable restraint.

Verbal abuse

Shouting and swearing at someone should be regarded as abusive behaviour.
In addition, speaking to a resident in a quiet but threatening way so
as to make the resident fearful or to make the resident an object of ridicule
is equally abusive.

Emotional abuse

Playing on someone's emotions to make him or her afraid, uneasy or unnecessarily
dependent is another form of abuse. Exploiting a resident through using
personal information gained through the caring relationship is an abuse
of the trust vested in the carer.

Abuse through the misapplication of drugs

The use of drugs to control or restrain a resident is unacceptable unless
medically required. The over-use and misuse of sedatives and other medication,
which too often happens in homes, should be regarded as evidence of bad
practice.

Financial abuse

Financial abuse includes the improper use or control of, or the withholding
of, a person's money, pension book, property, bank account or other valuables.

Racial abuse

Victimising people, verbally insulting them and physically attacking
them because of their racial or ethnic origin is abusive.

Sexual abuse

Forcing someone to take part in sexual activity against his or her will
is abuse and a criminal offence. The force does not have to be physical.
Undue emotional pressure placed on an individual may lead him or her to
acquiesce in behaviour he or she finds unacceptable.

Neglect

The withholding of care and treatment when it is required is a form of
abuse. Similarly, depriving residents of the essentials of everyday life,
such as food, clothes, warmth and personal cleanliness should also be
regarded as a form of abuse.

How and why abuse might occur

There are many reasons why abuse occurs in residential homes. They range
from the individual to the institutional:

· abuse may result from the actions of individual members of staff because
they lack the training, experience and management support to cope with
the stresses of caring for people who require a high level of assistance;

· occasionally it may occur because individual members of staff set out
deliberately to harm residents;

· more often, abuse occurs because the home, its managers and staff slip,
often without realising it, into a set of attitudes which reflects low
morale, defensiveness about their competence and a lack of concern and
respect for residents;

· over-work, lack of appreciation, low pay and low self-esteem may all
contribute to the development of an environment in which abuse becomes
an accepted feature of daily life.

Mellor Nook combats this by:

· careful staff selection procedures;

· training and management support for staff once in post;

· leadership from senior management;

· the development of a working environment which values staff, does not
demand too much of them and rewards them adequately.

Mellor Nook guards against:

· inadequate staffing levels to cope with a high incidence of incontinence;

· lack of trained and experienced care staff;

· absence of staff supervision by trained and experienced managers;

· terms and conditions of employment which do not provide holidays or
guarantee other basic employment rights;

· a casual approach to resident privacy where staff walk into rooms unannounced,
doors are left open when residents use the toilet, staff talk about residents
over their heads or divulge confidential information.

Prevention

Staffing procedures

The quality of life in the home is underpinned by the qualities of leadership
and competence shown by Jim, Eleanor and their seniors. Beyond
that, much depends on the calibre of the staff team. It is essential that
basic good practice in staff recruitment, training and supervision is
observed.

This involves:

· Mellor Nook takes up references, character checks and an enhanced Disclosure and Baring Services (DBS). We confirm written references by telephone calls;

· We provide regular supervision and appraisal sessions between manager
and individual staff members to provide support in coping with stressful
situations and to encourage staff;

· encouraging an atmosphere where staff feel able to discuss and therefore
prevent the development of potentially abusive situations;

· assuring staff that their jobs will not be threatened if they 'brow
the whistle' on abusive behaviour by other staff;

· making clear in the terms and conditions of employment and in the disciplinary
procedures that abusive behaviour is a dismissible offence. Instances
of serious abuse will be regarded as gross misconduct and subject to instant
dismissal and be reported to the adult protection unit. Lesser forms of
abuse will be subject to the formal disciplinary procedure and reported
to the C.Q.C., which if repeated would lead to dismissal;

Action to be taken if abuse occurs

If the situation is urgent, the person witnessing the abuse should:

· immediately challenge the person who is abusing the resident, even
though this may be difficult to do, and try to persuade him or her to
stop;

· report the incident to a senior manager straightaway.

If the immediate risk to the resident has passed a more considered approach
might be helpful. The person witnessing the abuse should:

· check which of the home's policies and guidelines have been broken,
or check against this guid; write down all the relevant facts;

· consider using the home's complaints procedure if appropriate;
or

· consider the most appropriate senior member of staff to approach and
whether it would be helpful to have another member of staff involved;

· ask for a confidential meeting with the most senior manager appropriate
at which the abuse is raised;

· the manager should then decide what action to take (for example, invoke
the disciplinary procedure, take evidence, call in the police or the adult
protection unit).

If the above action does not stop the abuse, or if the home's management
is involved or is unwilling to take the necessary corrective action, then
the person witnessing the abuse should:

· speak to another trusted member of staff if not already involved;
or

If at any time the situation involves something which is against the
law, or the resident or witness is in danger, the person concerned should:

· contact the police and ask for immediate help.

Other abuse

In some circumstances, staff themselves may be subject to abuse from
residents or residents may abuse each other. Sexual advances and verbal
abuse are not uncommon. Racist behaviour from and between residents can
and does occur. Staff may find this difficult to talk about and handle.
They may react inappropriately. Mellor Nook through its training and support
systems attempt to managing such behaviour.